<%--
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  User: 76554
  Date: 2023/4/25
  Time: 14:24
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--%>
<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<html>
<head>
    <meta charset="utf-8">
    <title></title>
    <style>
        .td1{
            text-align: center;
            background-color: #C3DAF2;

        }
        .td2{
            background-color: #E4EFF7;

        }
        .td3{
            background-color: #C7EDCC;
            width: 300px;
        }
        h4{
            width: 100%;
            background-color: #EBEBEB;

        }
        table tr td input{

        }
    </style>
</head>
<body>
<h4><img src="res/img/1.gif"/>&nbsp;病人诊断信息的录入</h4>
<form action="/saveBrxx" method="post">
    <table border="0"style="width: 96%;height: 0px;">
        <tr>
            <td class="td1">就诊卡号</td>
<%--            <td class="td2"><input type="text" name="jzkh" class="td3"/></td>--%>
            <td class="td1">病例编号</td>
            <td class="td2"><input type="text" name="blbh" class="td3"/></td>
        </tr>
        <tr>
            <td class="td1">病人姓名</td>
            <td class="td2"><input type="text" name="brxm" class="td3"/></td>
            <td class="td1">病人性别</td>
            <td class="td2"><input type="radio"name="brxb" value="男" checked="checked"/>男
                &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="radio"name="brxb"value="女" />女</td>
        </tr>
        <tr>
            <td class="td1">医生编号</td>
            <td class="td2"><input type="text" name="ysbh" class="td3"/></td>
            <td class="td1">医生姓名</td>
            <td class="td2"><input type="text" name="ysxm" class="td3"/></td>
        </tr>
        <tr>
            <td class="td1">医生职责</td>
            <td class="td2"><input type="text" name="yszc" class="td3"/></td>
            <td class="td1">药品名称</td>
            <td class="td2"><input type="text" name="ypmc" class="td3"/></td>
        </tr>
        <tr>
            <td class="td1">药品规格</td>
            <td class="td2"><input type="text" name="ypgg" class="td3"/></td>
            <td class="td1">药品数量</td>
            <td class="td2"><input type="text" name="ypsl" class="td3"/></td>
        </tr>
        <tr>
            <td class="td1">诊断结果</td>
            <td class="td2"><input type="text" name="zdjg" class="td3"/></td>
            <td class="td1">治疗方法</td>
            <td class="td2"><input type="text" name="zlff" class="td3"/></td>
        </tr>
        <tr>
            <td class="td1">就诊科室</td>
            <td class="td2"><select name="jzks"style="background-color: #FFFFFF;">
                <option value="内科">内科</option>
                <option value="外科">外科</option>
                <option selected="selected" value="儿科">儿科</option>
                <option value="妇产科">妇产科</option>
                <option value="骨科">骨科</option>
                <option value="眼科">眼科</option>
                <option value="口腔科">口腔科</option>
                <option value="五官科">五官科</option>
                <option value="肿瘤科">肿瘤科</option>
                <option value="皮肤病科">皮肤病科</option>
                <option value="中医科">中医科</option>
            </select></td>
            <td class="td1">诊断时间</td>
            <td class="td2"><input type="text" name="zdsj" class="td3"/></td>
        </tr>
       <table width="95%" border="0" align="center">
           <tr>
               <td align="center">
                   <input type="submit"  value=" 提交 ">
                   &nbsp;&nbsp; &nbsp; &nbsp;
                   <input name="submit" type="button"  value=" 返回 ">
               </td>
               <td>&nbsp;&nbsp;&nbsp;</td>
               <td>&nbsp;&nbsp;&nbsp;</td>
           </tr>
      </table>
    </table>
</form>
</body>
</html>

